This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://info.ahrq.gov. Let us know the nature of the problem, the Web address of what you want, and your contact information.

Grant Awards Relevant to Racial and Ethnic Minority Children

Fact Sheet, Fiscal Year 2002

In building research relevant to racial and ethnic minority children, the Agency for Healthcare Research and Quality (AHRQ) funded grants focusing on outcomes; quality and patient safety; and cost, use and access—AHRQ's three strategic goals. In addition, AHRQ funded grants for research on capacity building.

Outcomes

Title: Barriers to Care for Chronically Ill Vulnerable ChildrenPrincipal Investigator: Michael Seid, Children's Hospital Research Center, San Diego, CA.Grant No.: R03 HS13058 (03/01/02-02/28/03).Description: This project will help to develop and test a "Barriers to Care Questionnaire" in English and Spanish. The questionnaire will be used to identify and measure modifiable barriers to care that affect the link between vulnerability factors and health care structures, processes, and outcomes for Black, Hispanic and other children with special health care needs.

Title: Parenting Effects of Healthy Steps: Health Care Utilization and Expectations for Pediatric CarePrincipal Investigator: Cynthia Minkovitz, Johns Hopkins University, Baltimore, MD.Grant No.: R01 HS13086 (05/05/02-04/30/05).Description: This project will assess whether enhanced delivery of behavioral and developmental services in the first 3 years of life changes parental attitudes and practices when their children reach 5 years of age. Participants will include Black, Asian-American, Native American, Hispanic and other parents and their children.

Title: Medical Management of Children with Chronic ConditionsPrincipal Investigator: Frederick Connell, University of Washington, Seattle, WA.Grant No.: R03 HS13230 (10/01/02-09/30/03).Description: The aims of this study are to (1) develop an operational definition that can be used with Medicaid claims data to identify a child's medical home, and (2) examine the relationships between demographic factors and disease severity associated with having a medical home. The four chronic conditions to be investigated are asthma, diabetes, cerebral palsy and low-birth weight. African-American, American Indian, Asian-American and Hispanic/Latino children will be included in this study.

Whether associations between maternal depressive symptoms and children's receipt of services vary depending on the timing of symptoms.

Whether associations between maternal depressive symptoms and children's receipt of services vary depending on participation in the Healthy Steps program.

Participants will include Asian-American, Black, Native American, and Hispanic parents and their children.

Title: *Health of Grandparents Raising Their GrandchildrenPrincipal Investigator: Jan Blustein, New York University, New York, NY.Grant No.: R03 HS11747 (06/01/02-05/31/03).Description: This study will examine the following issues:

What is the impact of grandparents' care-giving on grandparent health status, health behaviors, and health care utilization patterns.

How do these impacts differ for grandparents heading households with different family configurations, i.e., split generation and three-generation households.

To what extent can these impacts be mitigated by the availability of tangible and social resources?

The three subgroups will include Black, Hispanic and other racial and ethnic minority groups.

Title: *Long-term Health Care Effects of Domestic ViolencePrincipal Investigator: Robert Thompson, Center for Health Studies, Seattle, WA.Grant No.: R01 HS10909 (07/09/02-04/30/06).Description: This study will assess the longitudinal impact of domestic violence on the health care utilization, patterns, and costs, and social functioning and health status of female and male victims and their children. African-American, Asian-American, Hispanic/Latino and Native American families will be included the analysis.

Title: *Violence and Spinal Cord Injury (VASCI): Understanding the Rehabilitation ContextPrincipal Investigator: Thilo Kroll, Medstar Research Institute, Washington, DC.Grant No.: R03 HS13039 (05/01/02-04/30/03).Description: The purpose of this qualitative study is to develop an in-depth understanding of the context and consequences of violently-acquired spinal cord injury (VASCI) through an inductive process, and to develop an evaluation plan for VASCI rehabilitation programs that will serve as a template for future program evaluations targeting interventions for African-American, Hispanic and other vulnerable populations.

Title: Parent-Initiated Prevention ProgramPrincipal Investigator: Dimitri A. Christakis, University of Washington, Seattle, WA.Grant No.: R01 HS13302 (09/30/02-09/29/06).Description: This randomized controlled trial will test a computer-driven, patient-centered expert system to improve the receipt of evidence-based prevention for pediatric patients. The study will assess the effectiveness of a real-time Parent-Initiated Prevention Program in changing physicians' delivery of preventive care as well as parental preventive behaviors. African-American, Asian-American, American Indian, Hispanic and other mixed/multi-ethnic families will be included in the analysis.

Title: Testing A New Measure of Quality of Asthma CarePrincipal Investigator: Yvonne Senturia, Jacobi Medical Center, Bronx, NY.Grant No.: R03 HS13081 (09/30/02-12/31/03).Description: This study will test the feasibility and validity of the Asthma Visit Questionnaire and a new measure to assess the quality of asthma care of poor inner-city American Indian/Alaskan Native, Hispanic, Black, Asian-American or Pacific Islander children with asthma. The measures will be tested in primary care settings.

Title: Quality of Life in Children after Liver TransplantationPrincipal Investigator: Estella Alonso, Children's Memorial Hospital, Chicago, IL.Grant No.: R03 HS13270 (09/30/02-09/29/04).Description: This cross-sectional study will (1) evaluate 150 children, including Asian-American, Black, Hispanic and Native American children, aged 12-18 at the 2-year anniversary of their transplant, (2) describe the health-related quality of life of children who survive liver transplantation, and (3) examine the impact of disease severity at transplant and the type of graft received on long-term health related quality of life.

Title: *The Impact of HMOs on DisparitiesPrincipal Investigator: Kevin Fiscella, University of Rochester, Rochester, NY.Grant No.: R01 HS10910 (09/30/02-09/29/05).Description: This project will (1) assess the scope and magnitude of racial/ethnic and socioeconomic disparities in HMOs, and (2) develop age, sex, and case-mix adjusted utilization and quality measures that examine racial/ethnic disparities in preventive care, satisfaction, change in health status, use of expensive hospital-based procedures, and avoidable hospital complications and mortality. This study will include Black, Hispanic, Asian-American and other racial and ethnic minority families.

Title: Partnership to Improve Children's Healthcare QualityPrincipal Investigator: Carole Lannon, National Initiative for Children's Healthcare Quality, Boston, MA.Grant No.: U18 HS13721 (09/30/02-09/29/06).Description: This project will bring together pediatric organizations to use their coordinated efforts and resources to support large-scale activities that have been shown to be effective in improving care for children. These partners will engage American Academy of Pediatrics' State chapters in evidence-based collaborative learning sessions along with an interactive Web-based quality improvement tool with the goal of supporting practice changes leading to improved care for children with attention-deficit hyperactivity disorder (ADHD). Hispanic, African-American, Asian-American, Native-American and Pacific Islander children with ADHD will be included in this study.

Title: *Evaluation of the Rewarding Results ProgramPrincipal Investigator: Gary Young, Boston University, Boston, MA.Grant No.: U01 HS13591 (09/30/02-09/29/06).Description: Under a grant administered by AHRQ, Dr. Young will conduct a comprehensive national evaluation of six projects. Four of the projects evaluated will address issues relevant to children/Medicaid populations. They include pediatric access, service and HEDIS scores, and asthma.

Cost, Use, and Access

Title: Child Mental Health and Mental Health Service UsePrincipal Investigator: Michael Ganz, Harvard University, Boston, MA.Grant No.: R03 HS13047 (04/01/02-09/30/03).Description: The aims of this project are to examine families' socio-economic status, clinical and insurance correlates of mental health conditions, and related services for Black, Hispanic and other children in the U.S.

Title: Disparities in Child and Family Health Care ExpendituresPrincipal Investigator: Paul Newacheck, University of California, S.F., San Francisco, CA.Grant No.: R01 HS11662 (07/01/02-06/30/04).Description: The aim of this project is to examine the extent to which disparities exist in out-of-pocket health care expenses for racial and ethnic minority families and children, and the role that health insurance plays in reducing or eliminating disparities.

Title: Costs of Care for VLBW InfantsPrincipal Investigator: Jeannette Rogowski, RAND Corporation, Santa Monica, CA.Grant No.: R03 HS13429 (09/30/02-09/29/03).Description: This descriptive study will use data from 29 hospitals in the Vermont Oxford Network to examine the costs and cost-effectiveness of care for VLBW Asian-American, Black, Hispanic, Native American and other racial and ethnic minority infants, and investigate how these costs of care vary with the degree of prematurity. The study will include 13,610 infants with birth weights under 1500 grams.

Title: Dental Access and Costs for Children in a SCHIP ProgramPrincipal Investigator: Peter Damiano, University of Iowa, Iowa City, IA.Grant No.: R03 HS13410 (09/30/02-09/29/04).Description: The purpose of this study is to determine dental services utilization for African-American, Hispanic and other children in the Iowa SCHIP, and African-American, Asian-American, Hispanic, Pacific Islander, Indonesian and other children in the Medicaid program. This study will also determine the factors related to unmet and "self-reported" dental needs for these children, and the costs associated with providing dental care for children in both programs and whether there is pent-up demand for dental care.

Title: Health Care Access for Children of the Working PoorPrincipal Investigator: Sylvia Guendelman, The Regents of the University of California, Berkeley, CA.Grant No.: R03 HS13411 (09/30/02-09/29/03).Description: This study will analyze data from the California Health Interview Survey to compare access and utilization of health care among working poor African-American, American-Indian/Alaskan Native, Asian-American, Latino, Hawaiian, and other Pacific Islander children with children in other socioeconomic strata. The study will also explore the differences in access and utilization of health care between immigrants and native born children of the working poor, and assess the extent to which expansions in health coverage for working poor parents can improve access and use of health services for their children.

Examine the prevalence of risky behaviors and their associated health care utilization and cost patterns in a pool of African-American, Hispanic and other racial and ethnic minority adolescents enrolled in Title XXI State Children's Health Insurance Program.

Examine the odds of engaging in risky behavior based on a psycho-social model that specifies predictive domains.

Examine the health care use and costs associated with risky behaviors and how these patterns are explained by social-demographic, health, psycho-social and community conditions.

Title: *Impact of Three Tier Prescription Drug Copay on Use and SpendingPrincipal Investigator: Dominic Hodgkin, Heller School for Social Policy and Management, Waltham, MA.Grant No.: R01 HS013092 (09/16/02-08/31/04).Description: This study will examine the impact of a three-tier prescription drug copayment program on drug and medical services utilization, expenditures, and therapeutic continuity of care, using enrolled patient cohorts in the Tufts Health Plan, a large HMO in Massachusetts. Part of this study will focus on five specific drug classes, and African-American, Hispanic and other racial and ethnic minority children will be represented among users of asthma and allergy medications, and possibly antidepressants.

Capacity Building

Grants for Primary Care Practice-Based Research Networks III (PBRNs)

The projects below support research in two categories:

Development/enhancement of network infrastructure.

Exploratory/pilot programs.

Title: Translating National Pediatric PBRN Research into PracticePrincipal Investigator: Eric Slora, American Academy of Pediatrics, El Grove Village, IL.Grant No.: R21 HS13512 (09/30/02-09/29/04).Description: Pediatric Research in Office Settings (PROS), a national network of over 500 pediatric practices, will develop a Web-based information system for posting of confidential practice-specific feedback reports, enhance minority representation in patient populations served by pediatricians in PROS, and test two different methods for translating research into practice on optimizing rates of pediatric immunizations.

Title: A Pediatric PBRN (Pediatric PitNet) and a Pilot ProjectPrincipal Investigator: Ellen Wald, Children's Hospital of Pittsburgh, Pittsburgh, PA.Grant No.: R21 HS13523 (09/30/02-09/29/04).Description: This new network of community and university-based pediatricians (Pediatric PitNet) will further develop its network infrastructure and conduct a pilot project to study methods of increasing adherence to recommendations for prevention of unintentional injuries, the most common cause of death and disability in young children. This study will include suburban middle-class families and urban and rural minority groups.

Title: CUBS: Preventive Services for At-Risk InfantsPrincipal Investigator: Robert Pace, Louisiana State University, New Orleans, LA.Grant No.: R21 HS13562 (09/30/02-09/29/04).Description: This new network of pediatric practices will work together to study the health and development of vulnerable children (African-American and Hispanic) who previously received care in the Louisiana State University's neonatal intensive care unit. The network will use standardized methods of information management and develop a common database adequate to support research.

Title: Continuity Research Network (CORNET)Principal Investigator: Janet Serwint, Ambulatory Pediatric Association, McLean, VA.Grant No.: R21 HS13582 (09/30/02-09/29/04).Description: This newly developed national network composed of pediatric practices will assess the health status and quality of care delivered to children belonging to racial/ethnic minority and underserved populations. The network will also examine health care disparities.

Title: Washington University Pediatric Research ConsortiumPrincipal Investigator: Jane Garbutt, Washington University, St. Louis, MO.Grant No.: R21 HS13530 (09/30/02-09/29/04).Description: This newly established network of community pediatricians affiliated with Washington University will establish a Web-based communication network to coordinate activities, enhance a computer interviewing system, and implement a faculty development plan to increase expertise among network members. Pediatric patients will include African-American and Hispanic children.

Title: Enhancement of the Technology Interface for the Cincinnati Pediatric Research GroupPrincipal Investigator: Thomas DeWitt, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.Grant No.: R21 HS13506 (09/30/02-09/29/04).Description: This regional network of pediatric providers will develop a system to allow electronic solicitation of data using handheld devices and wireless communications. Since the system will allow a real-time transmission of clinical impressions and symptoms, one of its intended uses is bioterrorism surveillance. Participants in this study will include African-American, Hispanic and other racial and ethnic minority children.

Title: Creating a Primary Care Practice-Based Research NetworkPrincipal Investigator: Louis Bell, Children's Hospital of Philadelphia, Philadelphia, PA.Grant No.: R21 HS13492 (09/30/02-09/29/04).Description: The Children's Hospital of Philadelphia network will develop an information system linking its pediatric practices. The network will create a project committee to assess potential research questions aimed at improving the delivery of primary care to urban, low-income African-American, Hispanic, and other racial/ethnic minority patients.

Title: Adherence in Children with Cystic Fibrosis and AsthmaPrincipal Investigator: Avani Modi, University of Florida, Gainesville, FL.Grant No.: F31 HS11768 (03/01/02-11/30/04).Description: The aims of this Predoctoral Award are to assess the extent of adherence problems in Black, Hispanic, and other racial/ethnic minority children with cystic fibrosis and asthma, compare patterns of adherence in two pediatric pulmonary populations, and identify key barriers associated with poor adherence.

Title: Doctor-Parent Communication and Antibiotic Over-prescribingPrincipal Investigator: Rita Mangione-Smith, University of California, LA, Los Angeles, CA.Grant No.: K02 HS13299 (09/30/02-09/29/07).Description: The aim of this Independent Scientist Award is to examine doctor-parent communication as a determinant of both inappropriate antibiotic prescribing and parent satisfaction with care. The study will then develop a communication-based intervention to decrease antibiotic over-prescribing in pediatric outpatient settings to improve the quality of patient care. Participants in this study will include Asian-American, African-American and Latino parents. This analysis will also include Asian-American, African-American, Latino and Middle Eastern physicians.

Title: Shared Decisionmaking and Inappropriate Antibiotic UsePrincipal Investigator: Elizabeth Cox, University of Wisconsin, Madison, WI.Grant No.: K08 HS13183 (07/01/02-06/30/07).Description: The aim of this Mentored Clinical Scientist Development Award is to develop and validate an instrument to measure shared decision-making in pediatric primary care, and to improve the quality of care and outcomes for children with upper respiratory infections. This study will include the racial and ethnic minority status of the physician, patient, and parent.

Title: Telemedicine for Children in Rural Emergency DepartmentsPrincipal Investigator: James Marcin, University of California, Davis, Davis, CA.Grant No.: K08 HS131179 (07/19/02-06/30/07).Description: The aim of this Mentored Clinical Scientist Development Award is to determine what impact telemedicine consultations have on the quality and satisfaction of care that critically ill and injured children receive in rural emergency departments. Participants will include racial and ethnic minority parents and children.

Title: Informative Technology: Linking Parents and ProvidersPrincipal Investigator: Stephen Porter, Children's Hospital, Boston, MA.Grant No.: K08 HS11660 (07/01/02-06/30/05).Description: The aims of this Mentored Clinical Scientist Development Award are to develop and test an electronic interface on the basis of user-perceived quality and the capture of valid data for asthma-specific history. Researchers will present parent-derived information to providers in the content of current evidence-based guidelines and assess the effects of this electronically-supported collaboration on parents' report of satisfaction and process measures of quality. African-American, Latino and other racial/ethnic parents and children will participate in this study.

Title: Modeling Health Utilization of Medicaid ChildrenPrincipal Investigator: David Rein, Georgia State University, Atlanta, GA.Grant No.: R03 HS13286 (09/30/02-02/28/03).Description: The aim of this Dissertation Award is to predict the health care expenses for the full population of Georgia Medicaid children (including American-Indian, Alaskan Native, Asian-American or Pacific Islander, Hispanic and Black children). Two leading forecasting models will focus on three goals: (1) To build a better predictive model of health service utilization, (2) address health policy relevant to children with special health care needs, and (3) build upon the behavioral model theory of who uses health services and why.

Title: *Improving Health Care Outcomes among the HomelessPrincipal Investigator: Margot Kushel, Regents of the University of California, San Francisco, CA.Grant No.: K08 HS11415 (03/01/02-02/28/07).Description: The aim of this Mentored Clinical Scientist Development Award is to examine the effects of different levels of community services (including housing, health care, and overall services) for homeless people on their use of hospitals and emergency departments. The study will include racial/ethnic minority adults and children. Researchers will also examine the cost-effectiveness of case-management as a strategy for improving health outcomes among HIV infected homeless people, and examine the health care utilization and public costs of a cohort of homeless persons under different policy options—supportive housing and usual care.

Title: *Emergency Department Crowding: Causes and ConsequencesPrincipal Investigator: Brent Asplin, HealthPartners Research Foundation, Minneapolis, MN.Grant No.: K08 HS13007 (03/01/02-02/28/07).Description: The aim of this Mentored Clinical Scientist Development Award is to determine the availability and time of outpatient appointments for medical and surgical conditions requiring urgent emergency department follow-up care according to insurance status. Project 1 of this study includes children, pregnant women, mentally disabled patients and elderly patients. The study population at ED sites will interact with investigators to complete survey instruments addressing ED crowding and patients' outcomes. Participants will be from racial and ethnic minority and non-minority groups.

Title: *Ethnography of the Social Ethics of Catholic Health CarePrincipal Investigator: Simon Lee, University of California-SF, San Francisco, CA.Grant No.: R03 HS13111 (09/30/02-06/25/02).Description: This Dissertation research project will investigate the role of Catholic religious values in the design of health care policy and service delivery intended for racial and ethnic minority populations.

Title: *Morehouse School of Medicine (MSM) Clinical Faculty Research Training ProgramPrincipal Investigator: Robert Mayberry, Morehouse School of Medicine, Atlanta, GA.Grant No.: R24 HS11617 (09/03/02-09/29/05).Description: The goals of this project are (1) to strengthen the MSM infrastructure by enhancing the capacity of individual faculty members to conduct health services research aimed at improving the quality of health services for African-Americans and other vulnerable populations, and (2) eliminate racial and ethnic health care disparities. This program will include research on barriers to prenatal care for women in low socioeconomic groups, improving immunization rates for low-income preschool children, and translating prevention research into primary practice.

*Project includes children or children's health care issues, but does not focus exclusively on children.

For More Information

For more information about child health activities at AHRQ, visit: https://www.ahrq.gov/child/